The air crescent sign of invasive pulmonary mucormycosis in acute leukemia

Funada, Hisashi; Misawa, Tadanobu; Nakao, Shinji; Saga, Tsutomu; Hattori, Kenichi

doi:10.1002/1097-0142(19840615)53:12<2721::aid-cncr2820531228>3.0.co;2-y

Cited by 35 publications

(16 citation statements)

References 13 publications

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“…The air crescent sign, which typically suggests invasive pulmonary aspergillosis, was present in 12% of 32 cases of mucormycosis reviewed by McAdams et al . [90,95]. In the same review of mucormycosis cases, 66% had consolidation and 41% had cavitation on chest radiograph [90].…”

Section: Pulmonarymentioning

confidence: 99%

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Mucormycosis and entomophthoramycosis: a review of the clinical manifestations, diagnosis and treatment

Prabhu

Patel

2004

Clinical Microbiology and Infection

502

422

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The class Zygomycetes is divided into two orders, Mucorales and Entomophthorales. These two orders produce dramatically different infections. Genera from the order Mucorales (Rhizopus, Mucor, Rhizomucor, Absidia, Apophysomyces, Cunninghamella and Saksenaea) cause an angioinvasive infection called mucormycosis. Mucormycosis presents with rhino-orbito-cerebral, pulmonary, disseminated, cutaneous, or gastrointestinal involvement. Immunocompromising states such as haematological malignancy, bone marrow or peripheral blood stem cell transplantation, neutropenia, solid organ transplantation, diabetes mellitus with or without ketoacidosis, corticosteroids, and deferoxamine therapy for iron overload predispose patients to infection. Mucormycosis in immunocompetent hosts is rare, and is often related to trauma. Mortality rates can approach 100% depending on the patient's underlying disease and form of mucormycosis. Early diagnosis, along with treatment of the underlying medical condition, surgery, and an amphotericin B product are needed for a successful outcome. Genera from the order Entomophthorales produce a chronic subcutaneous infection called entomophthoramycosis in immunocompetent patients. This infection occurs in tropical and subtropical climates. The genus Basidiobolus typically produces a chronic subcutaneous infection of the thigh, buttock, and/or trunk. Rarely, it has been reported to involve the gastrointestinal tract. The genus Conidiobolus causes a chronic infection of the nasal submucosa and subcutaneous tissue of the nose and face. This paper will review the clinical manifestations, diagnosis and treatment of mucormycosis and entomophthoramycosis.

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Section: Pulmonarymentioning

confidence: 99%

“…In the same review of mucormycosis cases, 66% had consolidation and 41% had cavitation on chest radiograph [90]. Crescentic cavitation can develop either during the neutropenic or postneutropenic phase [5,11,95].…”

Section: Pulmonarymentioning

confidence: 99%

Mucormycosis and entomophthoramycosis: a review of the clinical manifestations, diagnosis and treatment

Prabhu

Patel

2004

Clinical Microbiology and Infection

502

422

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“…disease [26,27]. Therefore, we assigned major diagnostic importance to C T scans and, in particular, to the halo sign.…”

Section: Value Of Thoracic Ct Scan For Ipa Diagnosismentioning

confidence: 99%

Role of early diagnosis and aggressive surgery in the management of invasive pulmonary aspergillosis in neutropenic patients

Caillot

Mannone

Cuisenier

et al. 2001

Clinical Microbiology and Infection

115

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Invasive pulmonary aspergillosis (IPA) occurs mostly in immunocompromised hosts and especially in neutropenic patients. Improved prognosis for IPA requires early diagnosis. We report our experience in the management of IPA in patients with hematological malignancies. In prolonged neutropenia (> 10 days), thoracic CT scanning seems to be the best choice for the diagnosis of IPA (with CT halo or air-crescent signs). Its systematic use allows a dramatic reduction in the time to achieve the diagnosis, if there is evidence of a halo sign. The systematic screening for the detection of Aspergillus antigenemia with an ELISA test is helpful for early diagnosis. The detection of Aspergillus antigen (with the less sensitive latex agglutination test) on bronchoalveolar lavage (BAL) fluid may also be as useful. The treatment of IPA relies on amphotericin B (or its lipid formulations) or on azole antifungal agents. Pulmonary surgical resection should be considered either as an emergency procedure (despite persistent neutropenia) to avoid massive hemoptysis, or as an elective or diagnostic procedure. This global strategy for the management of IPA is associated with a 75-80% success rate in hematological patients. Nevertheless, the control of underlying malignancy remains a major prognostic factor.

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“…The most frequent findings include infiltration, consolidation, nodules, cavitation, atelectasis, effusion, posterior tracheal band thickening, hilar or mediastinal lymphadenopathy and even normal findings [12][13][14]. The air crescent sign may be observed [15,16]. In a study of Computed Tomography (C. T. ) scan feature in 45 patients with HMs who had pulmonary mucormycosis or aspergillosis, Chamilos et al [17], found that the presence of multiple lung nodules >10 and pleural effusion on initial C. T. scan was an independent predictor of pulmonary zygomycosis.…”

Section: Discussionmentioning

confidence: 99%

Mediastinal Zygomycosis (Mucormycosis): an Unusual Manifestation of Invasive Zygomycosis (Mucormycosis), Presenting as a Mediastinal Mass in an Immunocompetent Adult Male

Ghatavat¹

2014

J Pulm Respir Med

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The common causes of mediastinal mass are neoplasms including Hodgkin's disease, neuroblastoma and nonHodgkin's lymphoma. About one third of the cases are benign such as teratomas, neurofibromas and lipomas. Histological findings are essential to distinguish between benign and malignant conditions. Zygomycosis is a rare fungal infection usually presenting as a subcutaneous infection. Visceral involvement is reported usually with pulmonary and gastrointestinal tract involvement. Here the authors report a case of zygomycosis in an immunocompetent adult male who presented with mediastinal mass.

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The air crescent sign of invasive pulmonary mucormycosis in acute leukemia

Cited by 35 publications

References 13 publications

Mucormycosis and entomophthoramycosis: a review of the clinical manifestations, diagnosis and treatment

Mucormycosis and entomophthoramycosis: a review of the clinical manifestations, diagnosis and treatment

Role of early diagnosis and aggressive surgery in the management of invasive pulmonary aspergillosis in neutropenic patients

Mediastinal Zygomycosis (Mucormycosis): an Unusual Manifestation of Invasive Zygomycosis (Mucormycosis), Presenting as a Mediastinal Mass in an Immunocompetent Adult Male

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